Comment: Why the NHS needs more clinical engineers

On the 21^st October the NHS’s engineering community will be taking part in the International Clinical Engineering Day; an opportunity to share and celebrate their achievements and to raise wider awareness of the work that they do in supporting patient care.  Yet, even though clinical engineering day has been celebrated globally since 2016, few people will have heard of it and even fewer will have ever seen a clinical engineer in their local hospital.

Back in 2017 I was asked by The Engineer to write an OpEd based on a report I had written for the Institution of Mechanical Engineers (IMechE) at the time, calling for a board-level Chief Engineer in every NHS trust. This policy encouraged the NHS to ensure cost savings and efficiencies were met in the development, procurement and maintenance of medical devices as well as driving technological innovation by engaging with its existing engineering community. Four years on, has anything changed?

Well, the NHS has been undergoing major reforms over those four years, to ensure it remains fit for purpose and affordable. However, all that has been somewhat thrown out of the window by the unexpected consequence of the current pandemic. Whether you are an engineer or not, it will have been hard for you to miss the media interest around the ‘ventilator challenge’, 90-minute COVID testing, rapid CPAP re-design and PPE manufacture, all of which has brought engineering in healthcare to the fore.

If action is not taken now to create sustainable strategies for technology adoption and greater engagement with the engineering specialists who oversee it, the NHS may be unable to propagate a coherent and cost effective approach to patient care in the future.

Government, wider society and even the NHS itself has recognised that engineers play a major role in managing patient care and that without their continued engagement and leadership, strategic decisions in technology adoption and innovation will be impossible to implement in any future healthcare service.

This new decade is expected to be nothing short of amazing when it comes to medical devices, healthcare apps and other in-vitro diagnostic tools, with an increase in multidisciplinary technology entering the sector; including personalised sensing, assistive devices and robotics which will herald a new wave of surgical innovation.

Since February, Clinical Engineers have been involved in responding to the pandemic across the UK by planning for and supporting the reconfiguration of hospital facilities and the expansion of critical care areas and equipment, including the Nightingale Hospitals.  As part of this they have been responsible for evaluating newly-acquired medical equipment and consumables for their suitability and effectiveness in clinical service which has resulted in them exploring different ways to effectively decontaminate medical devices. They have even been at the forefront of political decision-making, advising the Cabinet Office and hospital medical directors on device procurement and allocation, including developing a national software tool to return and redeploy centrally-procured equipment.

Expanding the clinical engineering workforce and developing fast training routes has also been highlighted by the pandemic and career opportunities within the NHS and outside it, in the medtech industry, are only set to grow as technological changes come online. While the traditional engineering fields such as mechanical, electrical and electronic remain the most common, there are increasing numbers of Biomedical Engineers entering the sector, with degrees focused specifically on medical applications.  Once in the NHS, Clinical Engineers study a broad range of physics, engineering, computing, management and analytical skills which they use to improve the diagnosis and treatment of disease and help with the rehabilitation of patients. Their role requires good communication and interpersonal skills, working with patients, clinicians, managers and equipment manufacturers. They also have to keep up to date with fast-moving scientific, medical and technological research and development, and lead project teams to deliver critical system changes.

The unfortunate result of our present situation has resulted in many engineers in traditional sectors losing their jobs, but the NHS clinical engineering community embraced their furloughed colleagues by demonstrating how engineer’s skills can be transferred to the clinical world.  I was fortunate to be directly involved in this, as I worked with the NHS and Royal Academy of Engineering to set up the recruitment of over 1000 engineers to a support the Nightingale hospitals. Some of these engineers have gone on to pursue clinical engineering career opportunities since then.

So, has anything changed since 2017?  I recently authored two new report on the engineering workforce and technology adoption within the NHS for the IMechE, which acknowledged the fact that there were still no chief engineers at board-level and that clinical engineers were still underutilised within the NHS. However, their contribution to patient care has started to be recognised by their employers and by Government. While this has been brought about by difficult and troubling times, it is a significant step none-the-less. The challenge now is for the clinical engineering community to sustain and cultivate this recognition and not to drift into the background once again.

If action is not taken now to create sustainable strategies for technology adoption and greater engagement with the engineering specialists who oversee it, the NHS may be unable to propagate a coherent and cost effective approach to patient care in the future.

I believe clinical engineers are now ready to move towards professional parity with their clinical counterparts. The realistic and long-term adoption and application of technology must include engineers who are able to implement innovations and adapt them to local environments; ensuring patients have a safe passage through our healthcare system.

Dr Helen Meese is founder & CEO of The Care Machine Ltd and Vice Chair of the IMechE Biomedical Engineering Division & Committee Member Pharma Group